Abstract
Many U.S. states have granted nurse practitioners (NPs) the right to practice and prescribe drugs without physician oversight, increasing the number of independent primary care providers. While existing studies show that full practice authority (FPA) increases access to primary care, thereby reducing the use of hospital services, less is known about its impacts on long-term care services. Using the Health and Retirement Study (HRS), we examine whether granting NPs full practice authority affects long-term care utilization. Exploiting the staggered adoption of states’ Scope-of-Practice laws during 1998-2018, we find that NP full practice authority has no significant impacts on nursing home use but individuals living in states with no practice restriction are less likely to use home care services. In FPA states, we find that individuals living in medically underserved areas experience a larger reduction in the use of long-term care services and inpatient care than the same individuals living in states with no primary care shortages. Regarding health outcomes, we find evidence that individuals living in states with FPA are less likely to report being in poor health and have fewer functional limitations. These findings indicate that granting NPs full practice authority does not have any negative health consequences. This is also suggestive evidence that FPA can help improve population health in medically underserved areas and achieve cost-saving through reductions in costlier services.
Details
Presentation Type
Paper Presentation in a Themed Session
Theme
Economic and Demographic Perspectives on Aging
KEYWORDS
LONG-TERM CARE, SCOPE OF PRACTICE, HEALTH AND RETIREMENT SURVEY
